JPH1099340A - Medical treatment implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to obtain a clamping power quantity sufficient for clamping and fixing soft vital tissues by forming an operation shaft of a superelastic member and disposing a pressing member which is pressed to treatment parts to operate the treatment parts to open when an optical shaft is deflected at the time of operating an operation handle to open into a sheath. SOLUTION: Clamping forceps 1 are provided with an insertion part 2 to be inserted into the celom through a trochal, etc. The treatment parts 3 are disposed at the front end of this insertion part 2 and the operation handle 4 to operate the treatment parts 3 is disposed at the base end of the insertion part 2. The insertion part 2 is provided with the slender hollow tubular sheath 5 and the treatment parts 3 are provided with a pair of clamping members 7, 8 for clamping the organs in the celom. The operation shaft 19 of the treatment parts 3 is formed of the superelastic alloy material exhibiting pseudo elasticity or superelasticity. The pressing member 31 consisting of a rigid pipe of the length approximately equal to the length of the operation shaft 19 is armored on the circumference of the operation shaft 19 into the sheath 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical treatment tool provided with a treatment section for, for example, grasping a living tissue.

[0002]

2. Description of the Related Art Generally, a medical treatment tool such as a grasping forceps is provided with a treatment section on the distal end side of an insertion section having a hollow tubular sheath. The treatment section is provided with a pair of openable and closable gripping members. Further, an operation handle is provided on the base end side of the insertion portion.

An operating shaft is provided in the sheath so as to be movable back and forth along the axis thereof. One end of the operation shaft is connected to the operation handle, and the other end is connected to the treatment section. Here, an opening / closing drive mechanism such as a link mechanism for opening / closing between the gripping members of the treatment section is provided at a connection between the treatment section and the operation shaft. Then, with the operation of the operation handle, the operating force of the operation handle is transmitted to the opening / closing drive mechanism of the treatment section via the operation shaft, and the opening / closing drive mechanism opens and closes the gripping members of the treatment section. .

As a medical treatment tool of this type, Japanese Patent Application Laid-Open No. 7-265326 discloses a grasping forceps having a configuration using a shape memory alloy exhibiting pseudoelasticity or superelasticity for an operation shaft. With this grasping forceps, when the operation force of the operation handle becomes unnecessarily large, the operation shaft is caused to elastically move to regulate the operation force for opening and closing the treatment section.

[0005]

SUMMARY OF THE INVENTION Japanese Patent Application Laid-Open No. 7-26532
In the grasping forceps disclosed in Japanese Patent Application Laid-Open No. 6-204, the maximum value of the grasping force amount (the operation force amount of the treatment section) is proportional to the elastic modulus of the elastic body constituting the operation axis. Therefore, for example, when grasping a soft biological tissue such as a lung, an operation shaft having a smaller elasticity and an easy extension is required.

Further, in order to reduce the elastic modulus of the operating shaft, the Young's modulus of an elastic body constituting the operating shaft must be reduced.
Alternatively, it is necessary to reduce the cross-sectional area of the operation shaft. Here, when a shape memory alloy is used as the elastic body for the operation shaft, it is difficult to greatly change the Young's modulus of the operation shaft.
Therefore, in this case, it is necessary to reduce the diameter of the operation shaft.
By reducing the diameter of the operation shaft, the maximum gripping force between the gripping members of the treatment section can be reduced.

In the above-mentioned conventional structure, when the gripping forceps are used, the slidability of the link mechanism of the opening / closing drive mechanism of the treatment section is reduced due to dirt or the like, so that it is difficult to open the gap between the gripping members. The operation force of the grasping forceps may increase. Further, in a state where a pair of grasping members of the treatment portion of the grasping forceps are inserted between the adhered living tissues, an opening / closing operation between the grasping members is performed, so that a technique of detaching the adherent tissue is performed. The operation force of the grasping forceps at the time of opening the gap increases.

However, when the diameter of the operating shaft is reduced, the operating shaft is likely to bend. Therefore, when the amount of operating force for opening and closing the space between the gripping members becomes large, the diameter of the small diameter when opening the space between the gripping members is increased. There is a possibility that even if the operation shaft is pushed out, the operation shaft is deflected so that it is impossible to open the gap between the gripping members.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances. It is an object of the present invention to obtain a sufficient amount of gripping force for gripping and fixing a soft living tissue and to increase the amount of operating force of a treatment unit. Another object of the present invention is to provide a medical treatment tool capable of reliably opening and closing the treatment section.

[0010]

According to the present invention, there is provided an insertion portion provided with a hollow tubular sheath, a treatment portion provided at the distal end of the insertion portion so as to be openable and closable, and a proximal end side of the insertion portion. An operating handle provided, the operating handle is provided in the sheath so as to be able to move back and forth along its axis, and one end is provided with the operating handle,
A medical treatment tool comprising: an operation shaft having the other end connected to the treatment section, transmitting an operating force of the operation handle to the treatment section, and opening and closing the treatment section in accordance with the operation of the operation handle. In, at least a part of the operating shaft is formed by a superelastic member that exhibits pseudoelasticity or superelasticity at room temperature, and inside the sheath, substantially parallel to the operating shaft, and along the axis of the sheath. A medical device provided with a pressing member which is arranged to be able to move back and forth, and which is pressed against the treatment section to open the treatment section when the operation shaft is bent when the operation handle is opened. It is a treatment tool. With the above configuration, when the operating shaft is bent when the operating shaft is pushed out during the opening operation of the operating handle, the pressing member is pressed against the treatment section,
The treatment section can be opened.

[0011]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of a grasping forceps 1 which is a medical treatment tool of the present embodiment. The grasping forceps 1 of the present embodiment is provided with an insertion portion 2 that is inserted into a body cavity through a trocar or the like (not shown). A treatment section 3 is provided at the distal end of the insertion section 2. Further, an operation handle 4 for operating the treatment section 3 is provided at a base end of the insertion section 2.

2 (A) and 2 (B)
As shown in FIG. 1, an elongated hollow tubular sheath 5 is provided. The sheath 5 is provided with a coating tube 6b made of an insulating material such as a polymer material on the outer peripheral surface side of a sheath body 6a made of a metal material such as stainless steel.

The treatment section 3 is provided with a pair of gripping members 7 and 8 for gripping an organ (for example, a gallbladder) in a body cavity. Here, a holding portion 9 for holding the gripping members 7 and 8 is provided at a distal end portion of the sheath 5. As shown in FIG. 3, the holding portion 9 is provided with a pair of holding arms 9a and 9b which are arranged to face each other. 3 and 4
As shown in FIG. 7, gripping members 7, 8 are rotatably supported by a support shaft 10 provided between the distal ends of the holding arms 9a, 9b.

The operating handle 4 has a fixed handle 1.
1 and a movable handle 12 are provided. Here, ring-shaped finger hooks 11a and 12a are provided on the base end (lower end) side of the fixed handle 11 and the movable handle 12, respectively.

Further, an insertion portion mounting portion 13 is provided on the distal end portion (upper end portion) side of the fixed handle 11. The insertion portion mounting portion 13 has an insertion portion mounting hole 13a to which the base end of the sheath 5 of the insertion portion 2 is mounted, and an operation shaft insertion hole 13b communicating with the insertion portion mounting hole 13a. The proximal end of the sheath 5 of the insertion section 2 is fixed to the fixing screw 14 while being inserted into the insertion section mounting hole 13a.
The fixing handle 11 is fixed to the insertion portion attaching portion 13 of the fixed handle 11. The operation shaft insertion hole 13b penetrates the wall of the insertion portion mounting portion 13 and is opened on the rear surface of the insertion portion mounting portion 13.

The fixed handle 11 is provided with a movable handle supporting portion 15 at an appropriate position between the insertion portion attaching portion 13 and the finger hook portion 11a. The movable handle 12 is rotatably connected to the support 15 via a support shaft 16.

An operating shaft mounting portion 17 is provided on the distal end (upper end) side of the movable handle 12. As shown in FIG. 2A, an operation shaft attachment groove 18 is formed in the operation shaft attachment portion 17. This operating shaft mounting groove 1
8 has a wide portion 18 having a large groove width as shown in FIG.
a and the narrow portion 18 having a smaller groove width than the wide portion 18a.
b. The narrow portion 18b of the operating shaft mounting groove 18 is disposed on the front (front end) side of the operating shaft mounting portion 17, and the wide portion 18a is disposed behind the narrow portion 18b.

The operating shaft 1 of the treatment section 3 is provided in the sheath 5.
9 is provided to be able to move back and forth along its axis. The operation shaft 19 is formed of a small-diameter rod-shaped member (super-elastic member) made of a super-elastic alloy such as a Ni-Ti-based shape memory alloy that exhibits pseudoelasticity or super-elasticity at room temperature.

Further, the base end side of the operation shaft 19 is fixed to the front end of the rear end connecting member 20 by a fixing method such as brazing. A substantially spherical connecting ball 21 is formed at the rear end of the rear end connecting member 20. The rear end connecting member 20 is provided with the operating shaft insertion hole 13 b of the fixed handle 11.
Extends to the rear side of the fixed handle 11.
Further, the connecting ball 21 of the rear end connecting member 20 is shown in FIG.
As shown in (C), the movable handle 12 is engaged with the wide portion 18a of the operation shaft mounting groove 18. The operation shaft 19 is held in the operation shaft mounting groove 18 of the movable handle 12 so as to be swingable about the connection ball 21 of the rear end connection member 20.

The distal end of the operating shaft 19 is fixed to the rear end of the link connecting member 22 by fixing means such as brazing. At the front end of the link connecting member 22, a pantograph-type link mechanism 23 for converting the forward / backward movement of the operation shaft 19 into the opening / closing operation of the pair of holding members 7, 8 of the treatment section 3 is provided.

As shown in FIGS. 3 and 4, the link mechanism 23 has a pair of rear extending portions 2 extending toward the rear of the support shaft 10 at the base ends of the pair of gripping members 7 and 8, respectively.
4 and 25 and a pair of links 26 and 27 are provided.

Here, the rear extension 24 of the gripping member 7 arranged on the upper side in FIG. 4 extends below the support shaft 10. The front end of one link 26 is rotatably connected to the rear end of the rear extension 24 via a connection pin 28. In addition, the rear extension 25 of the gripping member 8 arranged on the lower side in FIG. 4 extends above the support shaft 10. The front end of the other link 27 is rotatably connected to the rear end of the rear extension 25 via a connection pin 29. Further, the rear ends of the pair of links 26 and 27 are rotatably connected to the front end of the link connecting member 22 via connecting pins 30.

The fixed handle 1 of the operation handle 4
At the time of closing operation of the movable handle 12 in which the movable handle 12 is rotated clockwise about the support shaft 16 with respect to 1, the link mechanism 23 via the operation shaft 19 with the rotating operation of the movable handle 12 at this time. The connecting pin 30 of FIG.
In (A), a pull operation is performed to the right side. Further, the link mechanism 23 deforms with the movement of the connecting pin 30 at this time, and the link mechanism 23
The pair of gripping members 7 and 8 of the treatment section 3 are driven to rotate about the support shaft 10 in the closing direction by the deformation operation. Also, when the movable handle 12 is opened counterclockwise about the support shaft 16 with respect to the fixed handle 11 of the operation handle 4, the opening operation of the movable handle 12 is accompanied by the turning operation of the movable handle 12 at this time. Operation axis 19
2A, the connecting pin 30 of the link mechanism 23 is pushed to the left in FIG. 2A. Further, the link mechanism 23 is deformed by the movement of the connecting pin 30 at this time, and the pair of gripping members 7 and 8 of the treatment section 3 are moved by the deformation of the link mechanism 23.
It is driven to rotate about 0 in the opening direction.

The length of the operation shaft 19 is set such that the movable handle 12 of the operation handle 4 is closed and the pair of gripping members 7 and 8 of the treatment section 3 are completely closed. The length is set so that the strain when the film is elongated to about 2 to 10% or less.

FIGS. 2A and 2B show the inside of the sheath 5.
As shown in the figure, a pipe-shaped pressing member 31 made of a rigid body such as SUS is disposed around the operation shaft 19. The pressing member 31 is disposed substantially parallel to the operation shaft 19 and movably back and forth along the axis of the sheath 5.

The outer diameter of the pressing member 31 is determined by the outer diameter of the connecting members 22 and 20 before and after the operating shaft 19 (the outer diameter of the front end of the rear connecting member 20 and the outer diameter of the link connecting member 22). The diameter is set smaller than the outer diameter of the end portion. Further, the inner diameter of the pressing member 31 is set to be larger than the outer diameter of the operation shaft 19.

The movable handle 1 of the operation handle 4
When the operating shaft 19 is bent at the time of the opening operation, the pressing member 31 is pressed against the link connecting member 22 of the treatment section 3 to open the pair of gripping members 7 and 8 of the treatment section 3. Has become.

Next, the operation of the grasping forceps 1 of the present embodiment having the above configuration will be described. In the grasping forceps 1 of the present embodiment, when the movable handle 12 of the operation handle 4 is held in an open state, the grasping members 7, 8 of the treatment section 3 are held in an open state.

When the movable handle 12 is closed, the movable handle 12 is rotated clockwise about the support shaft 16 with respect to the fixed handle 11 of the operation handle 4.
At this time, the operating shaft 19 is pulled rightward in FIG. 2A with the turning operation of the movable handle 12, and the connecting pin 30 of the link mechanism 23 is moved through the operating shaft 19 in FIG.
In (A), a pull operation is performed to the right.

Further, the link mechanism 23 is deformed by the rightward movement of the connecting pin 30 at this time, and the pair of gripping members 7 and 8 of the treatment section 3 are centered on the support shaft 10 by the deformation of the link mechanism 23. The body tissue such as an in-vivo organ is gripped by the pair of gripping members 7 and 8 by being rotationally driven in the closing direction.

When an excessive operating force is applied to the movable handle 12 when the operating handle 4 is closed, the super-elastic alloy of the operating shaft 19 elastically expands, and the excessive force applied to the movable handle 12 is increased. Operation force is absorbed. Therefore, it is possible to prevent the excessive operating force applied to the movable handle 12 from being directly transmitted as the operating force for closing the pair of gripping members 7 and 8.

When the movable handle 12 is opened from a state in which the movable handle 12 is closed and the pair of gripping members 7 and 8 of the treatment section 3 are closed, the movable handle 12 is movable with respect to the fixed handle 11 of the operation handle 4. The handle 12 is rotated counterclockwise about the support shaft 16. At this time, the superelastic alloy of the operation shaft 19 that has been elastically extended is restored to the original length by the turning operation of the movable handle 12.

Subsequently, with the rotation of the movable handle 12 in the counterclockwise direction at this time, the operating shaft 19 and the pressing member 31 are pressed by the movable handle 12, and FIG.
Move to the left in (A). Then, the connecting pin 30 of the link mechanism 23 is pushed out to the left side in FIG. 2A via the operating shaft 19, and the link mechanism 23 is deformed with the movement of the connecting pin 30 at this time. The pair of gripping members 7 and 8 of the treatment section 3 are driven to rotate about the support shaft 10 in the opening direction by the deformation operation of the link mechanism 23.

When the opening operation of the pair of grip members 7 and 8 of the treatment section 3 is heavy during the opening operation of the movable handle 12 (the resistance of the opening operation of the pair of grip members 7 and 8 is large), the operating shaft is operated. 19 is bent by the compressive force, and the operation shaft 19 cannot open the space between the pair of holding members 7 and 8 of the treatment section 3. In this case, the pressing member 3 around the operation shaft 19
1, the link connecting member 22 is pushed forward, and the pair of gripping members 7, 8 of the treatment section 3 are opened.

Therefore, the grasping forceps 1 of the present embodiment having the above-described configuration has the following effects. That is, since the operation shaft 19 of the treatment section 3 is formed of a superelastic alloy material, if the operation force at the time of closing the movable handle 12 of the operation handle 4 becomes unnecessarily large, the operation shaft 19 becomes elastic. By performing the extension operation, the amount of operation force for closing the pair of grasping members 7 and 8 of the treatment section 3 can be regulated, and the living tissue grasped between the pair of grasping members 7 and 8 can be crushed. Breakage of the grasping forceps 1 itself can be reliably prevented. Therefore, a sufficient amount of gripping force can be obtained for gripping and fixing soft living tissue with the gripping forceps 1.

Further, since a pressing member 31 made of a rigid pipe having substantially the same length as the operation shaft 19 is provided inside the sheath 5 so as to be provided around the operation shaft 19, the movable handle 12 of the grasping forceps 1 is provided. At the time of the opening operation, the operating shaft 19 is bent by the compressive force, and the operating shaft 19
Even when it is not possible to open the space between the pair of gripping members 7 and 8 of the treatment section 3, the pressing member 31 pushes the link connecting member 22 forward to ensure the opening.
You can open the space. Therefore, at the time of opening the movable handle 12 of the grasping forceps 1, the pair of grasping members 7,
Even if the opening operation of the pair of gripping members 8 is heavy (the resistance of the opening operation of the pair of gripping members 7 and 8 is large), the operation shaft 19 having elasticity as in the related art is bent and the pair of gripping members of the treatment section 3 is bent. It is possible to prevent a situation where the space between 7 and 8 cannot be opened.

FIGS. 5A and 5B show a first modification of the grasping forceps 1 of the first embodiment (see FIGS. 1 to 4). In this modification, a notch 41 is formed on the peripheral wall of the pipe of the pressing member 31 in the grasping forceps 1 of the first embodiment along the axial direction.
The gap S of the notch 41 is set to a size slightly smaller than the outer diameter of the operation shaft 19. The configuration of other parts is the same as that of the grasping forceps 1 of the first embodiment.

Therefore, in this modification, the notch 41 is provided in the pressing member 31. Therefore, when the pressing member 31 is removed from the operating shaft 19, the notch 41 of the pressing member 31 is pressed against the operating shaft 19. As a result, the pressing member 31 is elastically deformed so as to widen the gap S between the notches 41, and the pressing member 31 can be easily removed from the operation shaft 19. For this reason, the cleaning and disinfection of the operating shaft 19 can be easily performed by removing the pressing member 31 from the operating shaft 19 during the cleaning and disinfecting work of the grasping forceps 1. Axis 1
As in the case where the operation shaft 19 is cleaned and disinfected while the operation shaft 9 is inserted, the operation shaft 19 and the pressing member 31 are used.
The workability of cleaning and disinfecting the operation shaft 19 can be greatly improved as compared with the case where a narrow and long gap is generated between the operation shaft 19 and the control shaft 19.

The notch 41 of the pressing member 31
Is smaller than the outer diameter of the operation shaft 19, so that the pressing member 31 does not come off the operation shaft 19 in a state where the pressing member 33 is mounted around the operation shaft 32.

FIG. 6 shows a second modification of the grasping forceps 1 of the first embodiment (see FIGS. 1 to 4). In this modification, a male screw portion 51 is formed at the rear end of the operation shaft 19 in the grasping forceps 1 of the first embodiment. Further, an operating shaft 19 is provided at the front end of the rear end connecting member 20.
A screw hole 52 to be screwed with the male screw part 51 of FIG.

In this modification, the male screw portion 51 of the operation shaft 19 is screwed into the screw hole 52 of the rear end connecting member 20 so that the pipe-shaped pressing member 31 can be detachably mounted around the operation shaft 19. It is configured to be attached to.

Therefore, in this modification, when the pressing member 31 is detached from the operation shaft 19, the male screw portion 5 of the operation shaft 19 is removed.
1 and the screw hole 52 of the rear end connecting member 20 are relatively rotated in a direction opposite to the screwing direction, and the operation shaft 1 is simply removed by unscrewing the operation shaft 19 and the rear end connecting member 20.
9, the pressing member 31 can be easily removed.
Therefore, the first modification (FIG. 5A,
As shown in (B)), the cleaning and disinfection of the grasping forceps 1 can be easily performed by removing the pressing member 31 from the operation shaft 19 during the cleaning and disinfection work. The workability of cleaning and disinfection can be greatly improved.

FIGS. 7A and 7B show a third modification of the grasping forceps 1 of the first embodiment (see FIGS. 1 to 4). In this modification, as shown in FIG. 7B, a fixing member 61 is fixed to the rear end of the operation shaft 19 in the grasping forceps 1 of the first embodiment by fixing means such as brazing. The outer diameter of the fixing member 61 is set smaller than the inner diameter of the pressing member 31.

Further, a male screw portion 62 is formed on the outer peripheral surface of the fixing member 61. Also, the rear end connecting member 20
As shown in FIG. 7 (A), a screw hole 63 is formed in the front end of the operation shaft 19 to be screwed with the male screw 62 of the fixing member 61 of the operation shaft 19.

In this modification, the male screw 62 of the fixing member 61 of the operation shaft 19 is connected to the screw hole 6 of the rear end connecting member 20.
3 to form a pipe-shaped pressing member 31.
Is detachably mounted around the operation shaft 19.

Therefore, in this modification, when the pressing member 31 is detached from the operation shaft 19, the fixing member 6 of the operation shaft 19 is removed.
The first male screw part 62 and the screw hole part 63 of the rear end connecting member 20 are relatively rotated in the opposite direction to the screwing direction,
The pressing member 31 can be pressed from the operating shaft 19 by simply removing the screw fixing between the fixing member 61 of the operating shaft 19 and the rear end connecting member 20.
Can be easily removed. For this reason, in this modification, the cleaning and disinfection of the operation shaft 19 can be easily performed by removing the pressing member 31 from the operation shaft 19 during the cleaning and disinfection work of the grasping forceps 1 as in the first modification. Therefore, the workability of cleaning and disinfecting the operation shaft 19 can be greatly improved.

Further, in this modification, since it is not necessary to thread the male screw portion 62 on the operating shaft 19 made of a superelastic alloy, which is originally difficult to machine, there is an effect that the manufacturing of the operating shaft 19 is facilitated.

FIG. 8 shows a second embodiment of the present invention. In this embodiment, a rod-shaped pressing member 71 made of a rigid body is used instead of the pipe-shaped pressing member 31 of the grasping forceps 1 of the first embodiment (see FIGS. 1 to 4).
Is provided.

Further, in this embodiment, an insertion hole 72 for inserting the rear end of the pressing member 71 is formed at the front end of the rear end connecting member 20 of the operation shaft 19. An insertion hole 73 into which the front end of the pressing member 71 is inserted is formed at the rear end of the link connecting member 22. The front end of the rod-shaped pressing member 71 is loosely inserted into the insertion hole 73 of the link connecting member 22, and the rear end of the pressing member 71 is similarly inserted into the insertion hole of the rear end connecting member 20. 72 is inserted in a loose fit state and is arranged in parallel with the operation shaft 19. The length of the pressing member 71 is set to be longer than the distance between the link connecting member 22 and the rear end connecting member 20 that occurs when the operating shaft 19 is extended to the maximum length using the grasping forceps 1. Have been.

In the present embodiment, the operation handle 4 is closed during the operation of closing the open movable handle 12.
The movable handle 12 is the support shaft 1 with respect to the fixed handle 11
6 is rotated clockwise. At this time, the operating shaft 19 is pulled rightward in FIG. 8 with the turning operation of the movable handle 12, and the connecting pin 30 of the link mechanism 23 is pulled rightward in FIG. Is done.

Further, the link mechanism 23 is deformed by the rightward movement of the connecting pin 30 at this time, and the pair of gripping members 7 and 8 of the treatment section 3 are centered on the support shaft 10 by the deforming operation of the link mechanism 23. The body tissue such as an in-vivo organ is gripped by the pair of gripping members 7 and 8 by being rotationally driven in the closing direction.

When an excessive operating force is applied to the movable handle 12 when the operating handle 4 is closed, the excessive elastic force of the operating shaft 19 elastically expands and the excessive force applied to the movable handle 12 is increased. Operation force is absorbed. Therefore, the grasping members 7 and 8 of the treatment section 3 do not close any more from the state of grasping the living tissue such as the internal organ, and the operating shaft 46 is not closed.
Is extended, only the closing operation of the movable handle 12 is performed. As a result, it is possible to prevent the excessive operation force applied to the movable handle 12 from being directly transmitted as the operation force for closing the pair of gripping members 7 and 8.

When the movable handle 12 is fully closed, the front end of the pressing member 71 is in the insertion hole 73 of the link connecting member 22, and the rear end of the pressing member 71 is in the insertion hole 72 of the rear connecting member 20. Are held in a state where they are hooked, respectively, so that the pressing member 71 is
There is no risk of deviating from between 2 and 20.

When the movable handle 12 is opened while the movable handle 12 is closed and the pair of gripping members 7 and 8 of the treatment section 3 are closed, the movable handle 12 is movable with respect to the fixed handle 11 of the operation handle 4. The handle 12 is rotated counterclockwise about the support shaft 16. At this time, the superelastic alloy of the operation shaft 19 that has been elastically extended is restored to the original length by the turning operation of the movable handle 12.

Subsequently, the operating shaft 19 and the pressing member 71 are pressed by the movable handle 12 with the counterclockwise rotation of the movable handle 12 at this time, and move to the left in FIG. Then, the connecting pin 30 of the link mechanism 23 is pushed out to the left in FIG. 8 via the operating shaft 19, and the link mechanism 23 is deformed by the movement of the connecting pin 30 at this time, and the link mechanism 23 is deformed. The pair of gripping members 7 and 8 of the treatment section 3 are driven to rotate about the support shaft 10 in the opening direction by the deformation operation.

When the opening operation of the pair of holding members 7 and 8 of the treatment section 3 is heavy during the opening operation of the movable handle 12 (the resistance of the opening operation of the pair of holding members 7 and 8 is large), the operation shaft is operated. 19 is bent by the compressive force, and the operation shaft 19 cannot open the space between the pair of holding members 7 and 8 of the treatment section 3. In this case, the pressing member 7 around the operation shaft 19
1 has a front end portion abutting against the inner bottom surface of the insertion hole 73 of the link connecting member 22, and a rear end portion of the pressing member 71 abuts against the inner bottom surface of the insertion hole 72 of the rear end connecting member 20. The connecting member 22 is pushed forward, and the pair of grasping members 7 and 8 of the treatment section 3 are opened.

Therefore, in the gripping forceps 1 of the present embodiment having the above-described configuration, similarly to the first embodiment, if the operation force for closing the movable handle 12 of the operation handle 4 becomes unnecessarily large, the operation is performed. By causing the shaft 19 to perform an elastic extension operation, the amount of operation force for closing the pair of holding members 7, 8 of the treatment section 3 can be regulated, and the shaft 19 is held between the pair of holding members 7, 8. Crushing of the living tissue and breakage of the grasping forceps 1 itself can be reliably prevented. Therefore, a sufficient amount of gripping force can be obtained for gripping and fixing soft living tissue with the gripping forceps 1.

Further, when the movable handle 12 of the grasping forceps 1 is opened, the operating shaft 19 is bent by the compressive force, so that the operating shaft 19 cannot open the pair of grasping members 7 and 8 of the treatment section 3. Even by pushing the link connecting member 22 forward by the pressing member 71,
The space between the pair of gripping members 7 and 8 of the treatment section 3 can be reliably opened. Therefore, when the movable handle 12 of the grasping forceps 1 is opened, the opening operation of the pair of grasping members 7 and 8 of the treatment section 3 is heavy (the resistance of the opening operation of the pair of grasping members 7 and 8 is large).
Even in this case, the operating shaft 19 having elasticity as in the related art is used.
Can be prevented from being bent so that the pair of gripping members 7 and 8 of the treatment section 3 cannot be opened.

Further, in this embodiment, particularly, since the pressing member 71 in the form of a thin rod is provided, the manufacturing is facilitated, and the pressing member 31 in the form of a pipe in the first embodiment is provided.
It is possible to eliminate the pipe lumen that is difficult to clean like
Detergency can be further improved.

FIGS. 9A and 9B show a modification of the second embodiment (see FIG. 8). In this modification, as shown in FIG. 9A, a fixing member 81 of the operation shaft 19 is detachably attached to the front end of the rear end connecting member 20 of the second embodiment.

As shown in FIG. 9B, the base end of the operation shaft 19 is fixed to the fixing member 81 by brazing at the axis thereof. Further, the fixing member 81 is formed with a through hole 82 through which the pressing member 71 of the second embodiment can be inserted.

Further, a male screw portion 83 is protrudingly provided at the rear end axial position of the fixing member 81. Further, at the front end of the rear end connecting member 20, a screw hole 84 to be screwed with the male screw 83 of the fixing member 81 is formed as shown in FIG. The configuration of the other parts is the same as that of the grasping forceps 1 of the second embodiment.

In this modification, when the grasping forceps 1 is washed, the rear end connecting member 20 is removed from the fixing member 81,
The pressing member 71 can be extracted from the through hole 82 of the fixing member 81. As described above, by removing the pressing member 71 from the through hole 82, the through hole 82 of the fixing member 81 is removed.
Cleaning of the inside becomes easy, and the cleaning property is improved.

FIGS. 10A and 10B show a third embodiment of the present invention. In this embodiment, an elongated plate-shaped pressing member made of a rigid body is used as shown in FIG. 10B instead of the rod-shaped pressing member 71 in the grasping forceps 1 of the second embodiment (see FIG. 8). 91 are provided.

Further, an insertion groove 92 for inserting the rear end of the pressing member 91 is formed on the outer peripheral surface of the front end of the rear end connecting member 20 of the operation shaft 19. Also, the link connecting member 2
An insertion groove 93 into which the front end of the pressing member 91 is inserted is formed on the outer peripheral surface of the rear end 2. Here, the insertion groove 9
The groove depths 2 and 93 are determined by the clearance between the rear end connecting member 20 and the inner peripheral surface of the sheath 5 and the link connecting member 22.
And the inner peripheral surface of the sheath 5 are set to a depth greater than the clearance between them.

In this embodiment, the rear end connecting member 2
0 insertion groove 92 and insertion groove 93 of link connecting member 22
Is larger than the clearance between the rear end connecting member 20 and the inner peripheral surface of the sheath 5 and the clearance between the link connecting member 22 and the inner peripheral surface of the sheath 5. Since the gripping forceps 1 are large, there is no possibility that the pressing member 91 comes off the insertion grooves 92 and 93 during use of the grasping forceps 1.

Further, the link connecting member 22 is inserted from inside the sheath 5.
And the rear end connecting member 20, the operating shaft 19, and the pressing member 9
By pulling 1 out of the sheath 5, the pressing member 91 can be naturally removed from the insertion grooves 92 and 93. Therefore, also in the present embodiment, the cleaning and disinfection of the operation shaft 19 can be easily performed by removing the pressing member 91 at the time of cleaning and disinfecting the grasping forceps 1.
The workability of cleaning and disinfecting the operation shaft 19 can be greatly improved.

FIG. 11 shows a fourth embodiment of the present invention. In this embodiment, a hollow operating shaft 19 made of a shape memory alloy is used instead of the small-diameter operating shaft 19 made of a superelastic alloy such as a shape memory alloy of the grasping forceps 1 of the first embodiment (see FIGS. 1 to 4). Is provided, and a rod-shaped pressing member 102 made of a rigid body is provided instead of the pipe-shaped pressing member 31 of the first embodiment.

Further, in this embodiment, the operation pipe 10
1 is fixed to the outer peripheral surface of the front end of the rear end connecting member 20 by a fixing method such as brazing. The distal end of the operation pipe 101 is fixed to the outer peripheral surface of the rear end of the link connecting member 22 by fixing means such as brazing.

Further, an insertion hole 1 into which the rear end of the pressing member 102 is inserted is provided at the axial center of the front end face of the rear end connecting member 20.
03 is formed. An insertion hole 104 for inserting the front end of the pressing member 102 is formed in the axial center of the rear end surface of the link connecting member 22. The front end of the rod-shaped pressing member 102 is loosely inserted into the insertion hole 104 of the link connecting member 22, and the rear end of the pressing member 102 is similarly inserted into the insertion hole of the rear end connecting member 20. 1
03 is inserted in a loose fit state and is arranged in parallel with the operation pipe 101. The length of the pressing member 102 is determined by the length of the link connecting member 22 and the rear end connecting member 2 generated when the operation pipe 101 is extended to the maximum length under the use of the grasping forceps 1.
The interval is set to be longer than the interval between zero and zero. The configuration of other parts is the same as that of the grasping forceps 1 of the first embodiment.

In this embodiment, when the operation of closing the movable handle 12 in the open state is performed, the movable handle 1 is closed.
11, the operation pipe 101 is pulled rightward in FIG. 11, the link mechanism 23 is deformed via the operation pipe 101, and the deformation of the link mechanism 23 causes the pair of the treatment units 3 to move. The gripping members 7 and 8 are driven to rotate about the support shaft 10 in the closing direction, and the pair of gripping members 7 and 8 grip a living tissue such as an in-vivo organ.

When an excessive operating force is applied to the movable handle 12 when the operating handle 4 is closed, the shape memory alloy (super-elastic alloy) of the operating pipe 101 is elastically extended, so that the movable handle 12 Excessive operation force applied to is absorbed. Therefore, the gripping members 7 and 8 of the treatment section 3 do not close any more from the state where the living tissue such as the body organ is gripped, and only the closing operation of the movable handle 12 is performed by the extension of the operation shaft 46. As a result, it is possible to prevent the excessive operation force applied to the movable handle 12 from being directly transmitted as the operation force for closing the pair of gripping members 7 and 8.

When the movable handle 12 is fully closed, the front end of the pressing member 102 is
The rear end portion of the pressing member 102 is held in the insertion hole 103 of the rear end connecting member 20 in a state where the pressing member 102 is caught from the front and rear connecting members 22 and 20, respectively. There is no risk of coming off.

When the movable handle 12 is opened from a state in which the movable handle 12 is closed and the pair of grasping members 7 and 8 of the treatment section 3 are closed, the movable handle 12 is movable with respect to the fixed handle 11 of the operation handle 4. The handle 12 is rotated counterclockwise about the support shaft 16. At this time, the shape memory alloy (super-elastic alloy) of the operation pipe 101 which has been elastically extended is restored to the original length by the turning operation of the movable handle 12.

Subsequently, with the turning operation of the movable handle 12 in the counterclockwise direction at this time, the operation pipe 101 and the pressing member 102 are pressed by the movable handle 12 and move to the left in FIG. And operation pipe 1
The deformation of the link mechanism 23 causes the pair of gripping members 7 and 8 of the treatment section 3 to rotate about the support shaft 10 in the opening direction.

When the opening operation of the pair of gripping members 7 and 8 of the treatment section 3 is heavy during the opening operation of the movable handle 12 (the resistance of the opening operation of the pair of gripping members 7 and 8 is large), the operation pipe is used. 101 is bent by the compressive force, and the operation pipe 101 cannot open the space between the pair of holding members 7 and 8 of the treatment section 3. In this case, the front end of the pressing member 102 inside the operation pipe 101 is connected to the link connecting member 22.
Since the inner bottom surface of the insertion hole 104 and the rear end of the pressing member 102 abut against the inner bottom surface of the insertion hole 103 of the rear end connecting member 20, respectively, the link connecting member 22 is pushed forward by the pressing member 102, The pair of gripping members 7 and 8 of the treatment section 3 open.

Therefore, in the grasping forceps 1 of the present embodiment having the above-described configuration, if the operating force for closing the movable handle 12 of the operating handle 4 becomes unnecessarily large, the operating pipe 101 is elastically extended. Is performed, the amount of operation force for closing the pair of gripping members 7, 8 of the treatment section 3 can be regulated, and the gripping between the pair of gripping members 7, 8 can be performed as in the first embodiment. Crushing of the living tissue and breakage of the grasping forceps 1 itself can be reliably prevented. Therefore, a sufficient amount of gripping force can be obtained for gripping and fixing soft living tissue with the gripping forceps 1.

Further, when the movable handle 12 of the grasping forceps 1 is opened, the operating pipe 101 is bent by the compressive force, and the operating pipe 101 is used to hold the pair of grasping members 7 and 8 of the treatment section 3.
Even if the space cannot be opened, the pressing member 1
02, the link connecting member 22 is pushed forward so that the pair of gripping members 7, 8 of the treatment section 3 can be surely pushed.
You can open the space. Therefore, at the time of opening the movable handle 12 of the grasping forceps 1, the pair of grasping members 7,
Even when the opening operation of the pair 8 is heavy (the resistance of the opening operation of the pair of gripping members 7 and 8 is large), the operation pipe 101 having elasticity as in the related art is bent and the pair of gripping members of the treatment section 3 is bent. It is possible to prevent a situation where the space between 7 and 8 cannot be opened.

In this embodiment, in particular, both ends of the operation pipe 101 are brazed and fixed to the connecting members 20 and 22, respectively, so that the inside of the operation pipe 101 can be hermetically sealed. Therefore, the gap between the pressing member 102 and the operation pipe 101 and the gap between the pressing member 102 and the insertion holes 103 and 104 are not exposed to the outside, and there is an effect that the cleaning property is improved.

In the grasping forceps 1 of the first embodiment, the grasping members 7 and 8 of the treatment section 3 may be provided with hardness detecting means for recognizing the hardness of the living tissue grasped. The hardness detecting means is provided on the operation handle 4 and a capacitance sensor comprising one or more sets of electrodes provided to face the contact surfaces of the grasping members 7 and 8 of the grasping forceps 1 which contact the living tissue. It comprises opening angle detection means for the movable handle 12.

Then, the thickness of the living tissue grasped by the grasping members 7 and 8 of the treatment section 3 is detected from the value of the capacitance sensor, and how much the operator grasps the movable handle 12 from the opening angle detecting means of the movable handle 12 is determined. Judgment,
The amount of deformation of the operating shaft 19 is estimated from the difference between the measured data of the thickness of the living tissue and the measured data of the gripping amount of the movable handle 12, and how much the operating shaft 19 is determined from the living tissue gripped between the gripping members 7 and 8. Is determined to be under stress, and the hardness of the living tissue is determined.

Further, a strain sensor or the like is provided on the operation shaft 19 of the grasping forceps 1 according to the first embodiment to directly detect the amount of deformation of the operation shaft 19, and the hard tissue of the living tissue grasped between the grasping members 7, 8 is hardened. Alternatively, a configuration may be adopted in which the height is detected.

FIG. 12 and FIGS. 13 (A) to 13 (D)
Is a grasping forceps 1 according to the first embodiment (see FIGS. 1 to 4).
14 shows a grasping forceps 111 with a bending function having a configuration different from that of FIG. The grasping forceps 111 is used for endoscopic surgery.

FIG. 13A shows a schematic configuration of the grasping forceps 111. The grasping forceps 111 includes the patient 1
An insertion portion 115 to be inserted into thirteen abdominal cavities 114 is provided. A treatment section 116 is provided at the distal end of the insertion section 115.
Are arranged. Further, an operation section 117 for operating the treatment section 116 is provided at a base end of the insertion section 115.

The insertion section 115 is provided with an elongated hollow tubular rigid sheath 118. This sheath 11
A first super-elastic pipe 119 is accommodated in 8.
Further, a second superelastic pipe 120 is accommodated in the first superelastic pipe 119. Here, sheath 1
18 and the first super-elastic pipe 119 and between the first super-elastic pipe 119 and the second super-elastic pipe 120 are held so as to be relatively movable in the axial direction.

Further, the first and second superelastic pipes 11
9, 120 is made of a NiTi-based alloy which is a superelastic material, and has a range several times larger than that of a normal metal.
Both superelastic pipes 119 and 120 are preformed into a curved shape by heat treatment in advance.

The base end of the second superelastic pipe 120 is fixed to the frame 121 of the operation unit 117. Further, a holding member 122 of the treatment section 116 is fixed to a distal end of the second superelastic pipe 120.

Further, as shown in FIG. 13B, the first and second superelastic pipes 119 and 120 have elongated engagement holes 11.
9a and 120a are formed respectively. Pins 123 projecting inward from the inner peripheral surface of the sheath 118 are engaged with the engagement holes 119a and 120a.
Therefore, the pin 123 of the sheath 118 and the engagement hole 11
9a and 120a prevents rotation between the sheath 118 and the first and second superelastic pipes 119 and 120. The first and second superelastic pipes 119 and 120 are set so that their preformed bending directions are opposite to each other. Here, the first superelastic pipe 119 is attached in a state where it is preformed in a curved shape directed to the lower left curving direction as shown in FIG.
For example, as shown in FIG. 13 (C), it is attached in a state where it is preformed into a curved shape directed to the upper left bending direction.

The treatment section 116 is provided with a pair of gripping members 124 and 125 for gripping a living tissue. These gripping members 124 and 125 are the second superelastic pipe 1
The holding member 122 at the distal end of the rotating member 20 is rotatably connected to a support shaft 126. Furthermore, these gripping members 12
A link-type opening / closing drive mechanism 127 having a pantograph structure is provided at the base end of the 4,125. The opening / closing drive mechanism 127 is connected to a distal end of an operation rod 128 inserted into the second superelastic pipe 120. The opening and closing drive mechanism 1 is pushed and pulled by the operation rod 128.
27 is driven, and the gripping members 124 and 125 are driven to open and close.

The operation section 117 includes a first operation knob 129 for operating the advance / retreat of the sheath 118, a second operation knob 130 for operating the advance / retreat of the first superelastic pipe 119,
Operating handle 131 for operating the operating rod 128
And are attached.

Here, a male thread worm 132 is formed at the base end of the sheath 118. Further, the first operation knob 129 is provided with a worm wheel 133 that meshes with the worm 132. Then, the worm wheel 133 is rotationally driven by the first operation knob 129, and the worm wheel 133 and the worm 13
The rotation of the worm wheel 133 is converted into an axial movement of the sheath 118 via the meshing portion with the sheath 2, and the sheath 118 is driven to move in the axial direction.

Further, a male thread worm 134 is similarly formed at the base end of the first superelastic pipe 119. Further, the worm 1 is attached to the second operation knob 130.
A worm wheel 135 meshing with the worm wheel 34 is provided. Then, the worm wheel 135 is rotationally driven by the second operation knob 130, and the worm wheel 1
The rotation of the worm wheel 135 is converted into an axial advance / retreat operation of the first superelastic pipe 119 through the meshing portion of the worm 134 and the worm 134, and the first superelastic pipe 119 is driven to advance / retreat in the axial direction. It has become so.

The operation handle 131 is provided with a fixed handle 136 and a movable handle 137 which can be opened and closed with respect to the fixed handle 136. The proximal end of the operation rod 128 is connected to the movable handle 137. The operating rod 128 is driven in the axial direction in accordance with the opening / closing operation of the movable handle 137, and the gripping members 124 and 125 are driven to open / close via the opening / closing drive mechanism 127.

Next, the operation of the above configuration will be described.
FIG. 12 shows a use state of the grasping forceps 111 in the endoscopic surgery. In this endoscopic surgery, the treatment is performed in a state where the grasping forceps 111, the rigid endoscope 112, and other treatment tools are separately and percutaneously inserted into the abdominal cavity 114 of the patient 113. .

Further, during the endoscopic surgery, the grasping forceps 1
The direction of the distal end of the insertion section 115 of the treatment section 11 is changed.
When the user wants to turn 6 toward the target portion, first, the first operation knob 129 is rotated.

When the first operation knob 129 is rotated, the worm wheel 133 is driven to rotate, and the rotation of the worm wheel 133 is moved in the axial direction of the sheath 118 through the meshing portion between the worm wheel 133 and the worm 132. The operation is converted to (retreat) operation, and the sheath 118 retreats along the axial direction. Therefore, as shown in FIG. 13D, the distal end of the first superelastic pipe 119 is exposed to the outside. At this time, the second superelastic pipe 120 is housed in the first superelastic pipe 119, but the first superelastic pipe 119 has a larger cross-sectional area than the second superelastic pipe 120. Therefore, the stability to the preformed curved shape is large. Therefore, the portion exposed to the outside of the sheath 118 is curved into the curved shape of the first superelastic pipe 119, that is, the curved shape directed to the lower left bending direction as shown in FIG. FIG.
In 3 (D), it can be directed to the target site facing downward and left.

The direction of the treatment section 116 is changed as shown in FIG.
In the case of turning in the opposite direction, the second operation knob 130 is rotated from the state of FIG. When the second operation knob 130 is rotated, the worm wheel 135 is driven to rotate, and the rotation of the worm wheel 135 is rotated in the axial direction of the first superelastic pipe 119 through the meshing portion between the worm wheel 135 and the worm 134. The first superelastic pipe 119 is retreated along the axial direction. Therefore, as shown in FIG. 13C, the tip of the second superelastic pipe 120 is exposed to the outside, and the tip of the second superelastic pipe 120 exposed at this time is the second tip. The curved shape of the superelastic pipe 120 is restored. As a result, the second superelastic pipe 12
Since the distal end portion of the treatment section 11 is curved in a curved shape directed to the upper left bending direction as shown in FIG.
13 can be directed to the target region facing upward and left in FIG. 13 (C).

In either the curved state shown in FIG. 13C or the curved state shown in FIG. 13D, the movable handle 137 is closed with respect to the fixed handle 136 of the operation handle 131, so that the operating rod is closed. 128 is driven in the axial direction and the gripping members 124 and 125 can be closed via the opening / closing drive mechanism 127.

When the bending of the distal end portion of the insertion portion 115 is released, the first operation knob 129 and the second operation knob 130 may be rotated in a procedure reverse to the above-described bending operation.

Therefore, the above configuration has the following effects. That is, since the bending of the distal end portion of the insertion portion 115 in two different directions can be realized by the first and second superelastic pipes 119 and 120 made of a superelastic alloy, a large bending angle can be obtained in both directions. it can.

Further, the insertion part 115 having a different tip
Since the bending in the direction can be realized, the internal organs may be damaged even in a narrow space as compared with the case where the bending operation of the distal end portion of the insertion portion 115 in one direction and the rotation operation of the insertion portion 115 around the axis are combined. Can be easily operated.

FIG. 12 and FIGS. 13 (A) to 13 (D)
The third and fourth super-elastic pipes may be further provided on the insertion portion 115 of the grasping forceps 111 shown in FIG. 4 and the tip of the insertion portion 115 may be curved in three or four directions.

FIGS. 14A to 14C are diagrams of FIG.
14A and 14B show a grasping forceps 141 with a bending function having a different configuration from FIGS. An elongated hollow tubular rigid sheath 143 is provided in the insertion portion 142 of the grasping forceps 141. In the sheath 143, the coil sheath 1
44 is inserted. The first and second superelastic members 145 and 145 having a substantially semi-cylindrical shape are provided on the outer peripheral surface of the coil sheath 144.
146 are arranged in a substantially cylindrical shape.
Here, the first and second superelastic members 145 and 146 are both preformed into a curved shape curved inward. Further, the first and second superelastic members 145 and 146 are held movably independently of the coil sheath 144 in the axial direction thereof.

FIG. 13 shows a base end of the insertion portion 142.
An operation unit 117 as shown in FIG. The coil sheath 14 is provided on the frame 121 of the operation unit 117.
4 is fixed at the base end.

Further, the operation unit 117 includes first and second
Operating knobs 147 and 148 are mounted. A rubber layer 149 is mounted on the surfaces of the first and second operation knobs 147 and 148. The first and second operation knobs 147 and 148 are held with the rubber layer 149 in contact with the outer peripheral surfaces of the rear ends of the first and second superelastic members 145 and 146, respectively. Then, by rotating the first and second operation knobs 147 and 148, the friction between the rubber layer 149 of each operation knob 147 and 148 and the first and second superelastic members 145 and 146 causes the first and second superelastic members 145 and 146 to rotate. The first and second superelastic members 145 and 146 are configured to slide in the front-rear direction along the coil sheath 144.

The treatment section 1 is provided at the distal end of the insertion section 142.
50 are provided. The treatment section 150 is provided with a pair of grasping members 151 and 152 for grasping a living tissue. These holding members 151 and 152 are connected to a holding member 153 at the tip of the coil sheath 144 so as to be rotatable around a support shaft 126 as shown in FIG. Further, a link-type opening / closing drive mechanism 127 having a pantograph structure as shown in FIG. 13A is disposed at the base end of these gripping members 151 and 152. The opening / closing drive mechanism 127 shown in FIG.
The tip of the operation rod 128 shown in FIG. The opening / closing drive mechanism 127 is driven by the pushing and pulling of the operation rod 128, and the gripping members 151, 15
2 is driven to open and close.

Next, the operation of the grasping forceps 141 having the above configuration shown in FIGS. 14A to 14C will be described. In the grasping forceps 141 having the above configuration, in an endoscopic surgical operation as shown in FIG. 12, when it is desired to change the direction of the distal end of the insertion portion 142 of the grasping forceps 141 so as to direct the treatment section 150 toward the target site, The first operation knob 147 or the second operation knob 1
One of 48 is rotated.

Here, when the first operation knob 147 is rotated, the first superelastic member 145 slides in the distal direction along the coil sheath 144 in accordance with the amount of rotation of the first operation knob 147. I do. Therefore, the grasping forceps 14
The tip of the first insertion portion 142 is a first superelastic member 145.
14 (B), ie, as shown in FIG. 14 (B), the treatment section 150 is bent in a downwardly curved direction. Can be directed to the target site.

Also, the orientation of the treatment section 150 is changed as shown in FIG.
When turning in the opposite direction, the first operation knob 147
Is rotated in the reverse direction to return the first superelastic member 145 to the original position, and then the second operation knob 148 is rotated.

When the second operation knob 148 is thus rotated, the second superelastic member 146 slides in the distal direction along the coil sheath 144 in accordance with the amount of rotation of the second operation knob 148. I do. Therefore, the grasping forceps 1
41 is inserted into the second superelastic member 14
6, that is, the treatment section 150 is curved in the upwardly-leftward curved direction as shown in FIG. 14C, and the treatment section 150 is turned to the upper left in FIG. 14C. To the target site.

In the gripping forceps 141 having the above-described configuration, the bending angle is adjusted according to the amount of sliding of the first and second superelastic members 145 and 146 by rotating the first and second operation knobs 147 and 148. Control is possible.

Therefore, the gripping forceps 141 having the above configuration has the following effects. That is, both of the two different curvatures of the distal end of the insertion portion 142 can be changed by the first and second superelastic alloys.
Since the second super-elastic members 145 and 146 have been realized, a large bending angle can be obtained in both directions.

Further, the insertion section 142 having a different distal end portion 2
Since the bending in the direction can be realized, the internal organs are damaged even in a narrow space as compared with a case where the bending operation of the distal end portion of the insertion portion 142 in one direction and the rotation operation of the insertion portion 142 around the axis are combined. Can be easily operated.

In the gripping forceps 141 having the above-described structure, the first and second superelastic members 145 and 146 having a substantially semi-cylindrical shape are arranged on the outer peripheral surface of the coil sheath 144 in a substantially cylindrical shape. Semi-cylindrical first and second
The superelastic members 145 and 146 allow the distal end of the insertion portion 142 to bend in two different directions, so that two substantially cylindrical superelastic members are used as bending means for bending the distal end of the insertion portion 142 in two different directions. This is more suitable for reducing the diameter of the insertion portion 142 than when using a member.

In the gripping forceps 141 having the above-described structure, the first and second superelastic members 145 and 146 each having a semicylindrical shape obtained by dividing the superelastic pipe into two parts are disposed in the insertion portion 142, and the first and second superelastic members are provided. Although the configuration in which the tip of the insertion portion 142 is curved in two different directions by the two superelastic members 145 and 146 is shown, the tip of the insertion portion 142 is curved in three or more different directions by dividing the superelastic pipe into three or more sections. A configuration may be adopted.

The present invention is not limited to the above-described embodiment, but may, of course, be variously modified without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Supplementary item 1) An insertion portion including a hollow tubular sheath, a forceps portion provided at the distal end side of the insertion portion so as to be openable and closable, and a pair of handle members provided at a base end side of the insertion portion. Operation handle, both ends of which are connected to the grip portion and the operation handle, respectively, and are provided in the sheath so as to be able to move back and forth along the axis thereof, at least a part of which is pseudoelastic or superelastic at room temperature. A forceps having an operation shaft made of a super-elastic member exhibiting elasticity, characterized in that the sheath has a pressing member arranged to be movable back and forth with respect to the operation shaft and substantially parallel to the operation shaft. And forceps.

(Additional Item 2) The forceps according to Additional Item 1, wherein the superelastic member is a shape memory alloy. (Additional Item 3) The forceps according to Additional Item 1, wherein the superelastic member has a rod shape or a tubular shape.

(Additional Item 4) An insertion portion formed of a hollow tubular sheath, a grip portion provided at the distal end of the insertion portion so as to be openable and closable, and a pair of handle members provided at a base end portion of the insertion portion are provided. An operation handle, a front end connected to the grip portion, and a rear end connected to the operation handle, at least a part of which is disposed within the sheath so as to be able to move back and forth along the axial direction thereof, is at least partly pseudo-elastic or superelastic at room temperature. A grasping forceps comprising an operating shaft made of a rod or pipe of a shape memory alloy exhibiting elasticity, having a length substantially equal to or longer than the already operated shaft in the sheath and being provided in parallel, freely moving back and forth with the operating shaft. Forceps having a simple pressing member.

(Purpose of Supplementary Items 1 and 4) A grasping forceps using an elastic body as an operation shaft has a sufficient amount of grasping force for grasping and fixing soft tissue, and even if the amount of operation force of the grasping portion is large. An object of the present invention is to provide a grasping forceps capable of reliably opening and closing a grasping portion.

(Operation of Supplementary Items 1 and 4) By providing a rigid pressing member having a length substantially equal to that of the operation shaft in parallel with the operation shaft, the holding member is held by the pressing member even if the operation shaft is bent. Can be pushed out to open the grip.

(Appendix 5) The forceps according to Appendix 4, wherein the pressing member is tubular. (Additional Item 6) The forceps according to Additional Item 4, wherein the pressing member has a rod shape and is provided substantially parallel to the operation axis.

(Additional Item 7) The forceps according to additional item 4, wherein the pressing member is detachable. (Effects of Additional Items 4 to 7) An object of the present invention is to provide a gripping forceps that gives elasticity to a gripping operation with a simple configuration without changing the structure of a conventional gripping forceps.

(Additional Item 8) The forceps according to additional item 4, wherein the operating shaft is tubular, and a pressing member is provided in the tubular operating shaft. (Effect of Additional Item 8) An object of the present invention is to provide a grasping forceps capable of regulating the upper limit of the amount of grasping force at the time of grasping operation with a simple configuration without changing the structure of the conventional grasping forceps.

(Additional Item 9) In the rigid treatment instrument, when a hollow insertion sheath and a first superelastic member which advances and retreats in the sheath, which is formed into a curved shape in a first direction, a sheath is formed. A second super-elastic member that advances and retreats within the second pre-elastic member, which is formed into a curved shape in a second direction different from the first direction; And an operating means for moving the superelastic member forward and backward.

(Prior Art in Appendix 9) Scissors, devices that can be operated remotely to observe and treat the inside of a living body
Although there are forceps, a suture instrument, a rigid endoscope, etc., all of them are devices housed in a rigid sheath, and the approach to an organ is straight. For this reason, the number of cases where the work area is limited and the treatment work becomes difficult has been reduced. In response to this problem, a device that bends the sheath tip using a wire pulling mechanism has been considered, but it is not practical because the bending portion loses its rigidity. Then, a curved device using a superelastic alloy such as US Pat. No. 5,254,130 has been proposed.

(Problem to be Solved in Supplementary Item 9) The problem is that the direction in which the superelastic alloy is greatly bent is only one direction in which the superelastic alloy is arranged, and the direction cannot be largely bent in a plurality of directions. In addition, although a rotating mechanism is shown as a means for directing in a different direction, it is necessary to be careful of an operator because rotating in a curved state may inadvertently damage a living body.

(Purpose of Supplementary Item 9) Provided is a rigid treatment tool with a curved shape, which can obtain a large curve in a plurality of directions and has a good approach to an object. (Additional Item 10) The first and second superelastic members are cylindrical, and the second superelastic member is housed inside the first superelastic member. (Subordinate item 9) (Additional item 11) The first and second superelastic members have a semi-cylindrical shape, and are arranged so as to face each other to form a cylindrical shape. (Subordinate item 9) (Additional item 12) The superelastic member is a NiTi-based alloy. (Subordinate to Appendix 9)

[0128]

According to the present invention, at least a part of the operating shaft is formed by a superelastic member exhibiting pseudoelasticity or superelasticity at room temperature, and is provided in the sheath substantially parallel to the operating shaft and at the same time. It is arranged to be able to move back and forth along the axis,
When the operation shaft is bent during the opening operation of the operation handle, a pressing member is provided that is pressed against the treatment section to open the treatment section, so that a sufficient amount of grasping force for grasping and fixing soft biological tissue is provided. It is possible to provide a medical treatment tool that can be opened and closed reliably even when the operation force of the treatment section is large.

[Brief description of the drawings]

FIG. 1 is a side view showing a grasping forceps according to a first embodiment of the present invention.

2A is a longitudinal sectional view of the grasping forceps according to the first embodiment, FIG. 2B is a sectional view taken along line BB of FIG. 2A, and FIG. FIG. 4 is a cross-sectional view showing a state where a connection ball of a rear end connection member of a shaft is engaged.

FIG. 3 is a plan view showing a link mechanism of a gripping member of the gripping forceps according to the first embodiment.

FIG. 4 is a longitudinal sectional view of a main part showing a distal end portion of an insertion portion of the grasping forceps according to the first embodiment.

FIG. 5A illustrates a first example of the grasping forceps according to the first embodiment.
(B) is a vertical sectional view of a main part showing a modification of (A).
B sectional drawing.

FIG. 6 is a longitudinal sectional view of a main part showing a second modified example of the grasping forceps of the first embodiment.

FIG. 7A is a third view of the grasping forceps of the first embodiment.
FIG. 13B is a longitudinal sectional view of a main part showing a modification of the first embodiment, and FIG. 14B is a longitudinal sectional view of the main part showing a state where a male screw part of a fixing member of the operating shaft is removed from a screw hole of a rear end connecting member of the modification.

FIG. 8 is a longitudinal sectional view of a grasping forceps according to a second embodiment of the present invention.

FIG. 9A is a longitudinal sectional view of a main part showing a modified example of the grasping forceps of the second embodiment, and FIG. 9B is a diagram illustrating a modified example of the modified example, in which a fixing member of an operation shaft is removed from a rear end connecting member. The longitudinal section of the important section showing a state.

FIG. 10 is a longitudinal sectional view showing a configuration of a main part of a grasping forceps according to a third embodiment of the present invention, and FIG. 10 (B) is a sectional view taken along line BB of FIG.

FIG. 11 is a longitudinal sectional view showing a configuration of a main part of a grasping forceps according to a fourth embodiment of the present invention.

FIG. 12 is a perspective view showing a use state of a grasping forceps having a configuration different from those of the first to fourth embodiments.

13A is a longitudinal sectional view of a main part showing a schematic configuration of the grasping forceps of FIG. 12, FIG. 13B is a sectional view taken along line BB of FIG.
(C) is a longitudinal cross-sectional view of a main part showing a curved state of the insertion portion of the grasping forceps, and (D) is a vertical cross-sectional view of a main part showing the curved state of the insertion portion of the grasping forceps in the opposite direction to (C). .

14A is a perspective view of a main part showing a schematic configuration of a grasping forceps having a configuration different from FIGS. 13A and 13B, and FIG.
Is a longitudinal sectional view of a main part showing a curved state of the insertion portion of the grasping forceps,
(C) is a longitudinal sectional view of a main part showing a curved state of the insertion portion of the grasping forceps in a direction opposite to that of (B).

[Explanation of symbols]

 2 Insertion part 3 Treatment part 4 Operation handle 5 Sheath 19 Operation shaft 31, 71, 91 Pressing member

Claims (1)

[Claims] An insertion section having a hollow tubular sheath; a treatment section provided at the distal end of the insertion section so as to be openable and closable; an operation handle disposed at a base end side of the insertion section; Provided in the sheath so as to be able to move back and forth along its axis, and one end is connected to the operation handle, and the other end is connected to the treatment section, and transmits the operation force of the operation handle to the treatment section, A medical treatment tool having an operation shaft for opening and closing the treatment section in accordance with the operation of the operation handle, wherein at least a part of the operation shaft is formed by a superelastic member exhibiting pseudoelasticity or superelasticity at room temperature. The treatment unit is disposed within the sheath so as to be movable back and forth substantially in parallel with the operation shaft and along the axis of the sheath, and when the operation shaft is bent when the operation handle is opened. Before being pressed against Medical treatment tool, characterized in that a pressing member for opening operation of the treatment portion.